Abstract

Background: Nocturnal enuresis affects up to 7 million school-aged American children,
leading to a host of negative psychological manifestations for patients and caregivers,
including lowered self-esteem. This study examined the effectiveness of a comprehensive
behavioral and educational nocturnal enuresis management program.

Methods: One hundred fifty patients aged between 5-17 years with nocturnal enuresis a
minimum of 5 nights a week for two months began the Center for Enuresis Control case
management program from December 1999 to September 2000. The program is a
comprehensive, multidimensional treatment plan with consistent follow-up. The program
included enuresis education, motivational counseling, enuresis alarms, physical
interventions, feedback, and bi-weekly report cards. Instructions were provided to the
participants directly over the phone and with follow-up written material. Self-esteem was
assessed using the Childhood Health Questionnaire (CHQ-PF28).

Results: One hundred fifteen patients were started on the program, 104 (90.4%) were
declared dry (69.3% of patients were dry on an intent-to-treat basis). Responders to the
program with a pre-intervention indication of impaired self-esteem experienced a 7.4%
increase in self-esteem scores.